In the world of cardiology, where every second counts, complexities in billing are often ignored and given a back seat. And above that, there is a diagnostic and therapeutic divide which further creates a lot of difficulties with cardiology billing. However, it can’t be ignored that driving ROI (Return on Investment) is very much dependent on finding the right medical billing software for cardiology billing. The main task it performs is to streamline your reimbursement process.
The rules and guidelines in medical billing process of cardiology keeps on fluctuating every now and then. The need of the hour is to get a medical billing software for cardiology billing which have a disciplined understanding of the latest guidelines in cardiology billing and coding. Creating the right approach demands special expertise and a software that knows what it takes to deliver exceptional support. An expert medical billing software like Unify Medicraft knows how to drive your revenue and bring justice in your reimbursement approach.
Another important thing is to choose your software wisely that knows how to drive your collections by eliminating both front and back-end challenges.
Today’s Healthcare organizations, including cardiology need to ensure every aspect of their practice is running smoothly and efficiently. As organizations strive for excellence in patient care, it is also important to ensure the administrative side of your practice is equally efficient and seamless. After all, financial stability is essential for every organization, and your cardiology practice is no different.
For a cardiology practice to thrive, financial viability is the ultimate key. If you want to ensure a healthcare organization that generates maximum revenue requires not only good healthcare service but also sound financial processes.
In this simple yet informative blog, we will provide you with all the information that will help you master the cardiology billing process. We will cover various aspects of accurate and efficient medical billing practices. Whether you’re a healthcare provider or a medical practice manager, this blog will help you navigate the complex world of cardiology billing.
Cardiology Medical Billing Process
Patient Check-in and Registration
The medical billing process in cardiology starts the moment the patient gets registered with your healthcare facility. Collection of patient information begins at this point. The staff that is responsible for collecting details like the medical history of the patient and their insurance coverage must ensure all the data is collected and recorded accurately.
Documenting Medical Services
As soon as you as a cardiologist sees the patient, makes an assessment, and performs medical services which includes running diagnostic tests and issuing treatments, detailed documentation of these services must be done.
Proper Coding of the Services
After the documentation is done, medical coders who are properly trained in cardiology must input the services as per standardized codes. If there is any error here, it will seriously impact the upcoming steps.
Generation of Claims
The next step is to now use the codes to create claims from the insurance company or other payer of the patient.
Submission of Claims
After the claims are fully generated, they are submitted along with all the supporting documentation.
Proper Claim Review and Processing
The claim submitted by you is then reviewed by the insurance company (or the payer). They deeply analyse the codes & documentation along with the patient’s insurance coverage.
Payment and Claims Adjudication
Insurance providers will then study the claims. All the incomplete or inaccurate claims are returned for clarifications. For all the claims that are approved, payment amounts are calculated as per the procedures conducted and the insurance coverage of the patient.
Denial Management
There can be a case when a claim is denied. In this case, the billing team investigates the reason for the denial and takes appropriate actions to appeal or rectify the entire issue. This may include re-submitting the claim with the addition of documentation.
Patient Billing and Calculation
There are times when patients need to cover a part of their bill due to copayments or in case if the coverage doesn’t cover some of the treatments. Healthcare service providers need to reconcile payments received from insurance companies and the patients with the billed amounts.
Reporting and Compliance
Healthcare service providers must maintain complete and accurate financial records. This helps to track revenue, expenses, balances, various other aspects. Proper record maintenance allows timely economic analyses and keeps the practice in good state for fulfilling compliance requirements. In the time of an audit, having your paperwork in place can help a lot for making the process feel less pain.
It is certainly not easy to carry out the entire process of Cardiology medical billing efficiently without any professional help if you don’t want to compromise your patient care. That is where Unify Medicraft – your professional medical billing software comes into the scene.
Challenges in Cardiology Medical Billing
Understand Modifiers for Cardiology
Cardiology billing is difficult and requires knowledgeable professionals to perform appropriate medical coding & billing procedures. Various billing details such as medical necessity verification, coding, etc., demands the level of billing expertise and efficiency.
Modifiers are one of the crucial components in the entire medical coding process. If they are used not correctly used, it will impact your overall revenue cycle. When we use the correct modifiers, revenue speed is increased, and audit compliance is improved. Medical billing software for cardiology billing like Unify Medicraft will work with your practice to find out the problem areas such as the correct use of modifiers and maximize the revenues for the services rendered by you.
Inaccurate Documentation
Inaccurate documentation leads to coding inconsistencies that directly impact your revenue cycle. This leads to decreased reimbursements. Unify Medicraft takes care that every procedure is properly documented, and no potential code is missed. Documentation should include supplies used, medications used outside the standard, and every other procedure.
Understand the Combo Codes
In ICD-10-CM, a lot of combination codes are available for cardiology coding. Based on the patient’s conditions accurate combination code need to be used. Your medical billing software – Unify Medicraft understand all the combo codes used in Cardiology, which further smoothens the entire billing process.
Focus on Diagnosis Instead of Symptom Coding
In such cases, when symptom reporting is not needed, you must try to avoid the symptom coding. When the diagnosis is confirmed for patients, only then use the diagnosis report and avoid the cases of symptom coding. According to ICD-10 official guidelines, symptoms are not usually associated with a disease that may be reported.
With so much of the healthcare sector already involved in several subdivisions and sub-specializations, it is no surprise to see various providers considering getting a medical billing software for cardiology practice.
Unify Medicraft – A Right Choice for Cardiology Medical Billing
Helpful in Claim Generation and Submission
The software is quite capable of generating accurate and compliant insurance claims based on the provided information. It supports electronic claim submission to insurance companies which results in faster processing and reimbursement.
Insurance Verification
All the integrated tools for verifying patient insurance information helps to prevent claim denials due to coverage issues. It includes checking patient eligibility and coverage details before any appointments.
Effective Revenue Cycle Management
Effective revenue cycle management tools help to track and manage the financial aspects of your cardiology practice. It includes monitoring accounts receivable and resolving billing issues at once.
If you’re managing a cardiology practice, Unify Medicraft as your medical billing partner can be a game-changer. Our smart software solution ensures that your healthcare practice’s financial systems are up to date in every sense. From process to technology to regulatory compliance. Not only will it help streamline your billing process, but it will also take a huge burden off your practice. It will allow you and your healthcare team to focus on their core job of actively serving patients.